Arthroscopic Fixation of Posterior Cruciate Ligament Avulsion Injury Using a Simplified Technique: A 1-Year Follow-Up...

Posterior cruciate ligament (PCL) tibial avulsion fractures require accurate reduction and stable fixation to restore knee stability. Traditional open techniques are invasive, and although arthroscopic approaches have shown promise, complex fixation methods may not be suitable for all populations. This study evaluates the clinical and functional outcomes of arthroscopic single-tunnel suture fixation for PCL avulsion injuries.

A prospective cohort of 37 patients (26 males, 11 females; mean age 28.35 ± 5.36 years) with acute PCL tibial avulsion fractures underwent arthroscopic single-tunnel fixation using a suture-disc technique in two tertiary care level hospitals in Kolkata, West Bengal. Functional outcomes were assessed using the Lysholm Knee Score at five timepoints (pre-op, and 3-, 6-, 9-, and 12-month post-op). Posterior laxity, range of motion (ROM), radiographic union, and complications were evaluated. Non-parametric statistical tests, including Friedman and Wilcoxon signed-rank tests with Bonferroni correction, were applied to assess score progression.

All patients achieved bony union within 8-12 weeks and regained a mean flexion range of 0°-138.5° (SD 3.5). Posterior drawer tests normalized in all cases by final follow-up. The Lysholm score significantly improved over time (χ ² = 74.71, p < 0.000001), with all pairwise comparisons remaining statistically significant. No vascular, neurological, or wound complications were reported. Comparative discussion with existing literature supports the efficacy, safety, and simplicity of this technique.

Arthroscopic single-tunnel suture fixation is a minimally invasive, effective, and reproducible technique for managing PCL tibial avulsion fractures, offering excellent outcomes with low complication rates.